CN1225229C - Video rectoscope - Google Patents

Abstract

A video endoscope (20) includes a generally rigid, elongate insertion member (22), having distal and proximal ends, and a video camera head (30) fixed at the distal end of the insertion member. A sheath (26) fits over and covers the insertion member, the sheath having a distal portion covering the video camera head, at least a section (36) of which distal portion is substantially transparent.

Description

video camera proctoscope

technical field

The present invention relates generally to medical probes, and in particular to endoscopes.

Background technique

For visual inspection and diagnosis of the colorectum and sigmoid colon, various types of endoscopes are known in this technical field. Rigid proctoscopes and sigmoidoscopes are most commonly used because they are durable, easy to use, and relatively inexpensive.

To perform an examination with a rigid proctoscope (or sigmoidoscope), the doctor first inserts the speculum through the anus. For ease of insertion, the scope is plugged with a plug protruding from its distal end with a blunt rounded distal portion. Once the speculum is in place, the doctor will remove the plug and seal the proximal end of the speculum with a plug. A special telescope is mounted in the plug, allowing the physician to view the interior of the rectum and sigmoid colon at the distal end of the scope, either directly or by means of a video camera attached to the proximal end of the telescope. In order to illuminate the area to be observed, a light source in the external control cabinet is connected to the proximal end of the sight glass through an optical fiber. Typically, the plug also contains one or several working channels for insufflation, air insufflation or insertion of surgical instruments through the scope.

Various proctoscopes and sigmoidoscopes of this type are commercially available. For example, Karl Storz GmbH (company name) in Tuttlingen, Germany can supply a proctoscope model 24911S, which can be viewed directly with the aid of a rod lens telescope (type 24946B for example) or through a Karl Storz endoscopic video camera rectum. The rectoscope and its accessories are made of stainless steel and can be sterilized and disinfected between uses.

Proctoscopes and sigmoidoscopes with disposable scopes and plugs are also commercially available, such as the KleenSpec (trade name) disposable sigmoidoscope from Welch Allyn Inc. (Company name), Skaneateles, NY. Its peep mirror and plug are made of plastics. The scope is clipped or threaded to a multipurpose handle that can accommodate light sources, telescopes, cameras, and instruments.

Flexible sigmoidoscopes and colonoscopes are also known in the art. Most of these colonoscopes contain a fiber optic bundle that transmits images of the inside of the large intestine at the distal end of the colonoscope to an eyepiece or video camera mounted at the proximal end. Some flexible colonoscopes have a CCD (charge-coupled device) detector with an objective lens at their distal end, such as the Pentax ES-3801PVE video camera sigmoidoscope manufactured by Asahi Optical Company (company name) in Tokyo, Japan. However, compared with rigid proctoscopes and sigmoidoscopes, flexible scopes are expensive, fragile, and difficult to clean.

Contents of the invention

It is an object of certain features of the invention to provide an improved endoscope, in particular an improved proctoscope.

It is an object of certain features of the present invention to provide a video camera proctoscope that improves visibility of anatomical features within the rectum.

Another object of certain features of the present invention is to provide a proctoscope that is easy and convenient for medical personnel to use.

It is a further object of certain features of the present invention to provide a proctoscope with easily replaceable single-use portions, thereby minimizing or eliminating the need for sterilization and disinfection between uses.

It is a further object of certain features of the present invention to provide methods and apparatus for facilitating the insertion of an endoscope, particularly a proctoscope or sigmoidoscope, into a body cavity.

It is a further object of certain features of the present invention to provide an improved endoscope guidance mechanism.

According to an aspect of the present invention, a kind of video camera endoscope is provided, it comprises:

a generally rigid elongated insertion unit having a distal end and a proximal end;

a video camera affixed to the distal end of the insertion unit; and

a sleeve removably fitted over and covering the insertion unit, having a distal portion covering the video camera, at least a portion of the distal portion being substantially transparent,

wherein the distal portion of the sleeve includes a narrow tip that facilitates insertion of the endoscope through the anus, and

The narrow tip therein comprises two or more blades which are closed when inserted through the anus and which are opened after insertion to expose a transparent portion of the distal portion of the sleeve.

Preferably, in order to open the blades, the sleeve is pulled in a proximal direction relative to the insertion unit.

Preferably, the sleeve contains a working channel running longitudinally through it, and

Wherein the sleeve contains a one-way valve in its working channel, which is used to prevent the backflow of the fluid flowing therein.

By following detailed description of some preferred embodiments of the present invention in conjunction with the accompanying drawings, the present invention will be more fully understood, in the accompanying drawings:

Description of drawings

Fig. 1 is a schematic partial sectional view of a rectoscope according to a preferred embodiment of the present invention;

Fig. 2 is a detailed cross-sectional view of the distal portion of the rectoscope in Fig. 1;

3A and 3B are schematic cross-sectional views of a proctoscope covered by a sleeve in a closed state and an open state, respectively, according to another preferred embodiment of the present invention;

4A is a schematic cross-sectional view of the distal portion of a rectoscope according to another preferred embodiment of the present invention;

Figure 4B is a schematic diagram of the video image acquired by the rectoscope in Figure 4A;

Figure 5A is a schematic cross-sectional view of the distal portion of a rectoscope according to a preferred embodiment of the present invention;

5B is a schematic cross-sectional view of a rectal inserter particularly adapted for use with the rectoscope of FIG. 5A in accordance with another preferred embodiment of the present invention; and

Fig. 6 is a schematic cross-sectional view of a proctoscope according to yet another preferred embodiment of the present invention.

Detailed ways

Reference is now made to FIG. 1, which is a schematic partial cross-sectional view of a video camera proctoscope 20 in accordance with a preferred embodiment of the present invention. Proctoscope 20 includes an insertion portion 22 insertable into the patient's rectum and a handle 24 for the examining physician to grasp. The insertion part 22 includes an insertion unit 28 secured to the handle 24 and a disposable sleeve 26 covering the insertion unit. Unit 28 contains a video camera 30 at its distal end, which is connected to handle 24 by wires 32 . Sleeve 26 is preferably made of a biocompatible plastic material such as polycarbonate, and is connected to handle 24 by a quick-connect means known in the art. The sleeve 26 is to be removed and discarded after use.

FIG. 2 details a schematic cross-sectional view of the distal end of insertion portion 22 containing camera head 30 . The camera comprises a detector array chip 46, preferably comprising a color CCD array 50 such as Sony's ICX087AKB CCD chip, with a suitable optical filter 48 disposed thereon. One or several lights 42 illuminate the large intestine area in the field of view of the camera. An image of the area is received through optical window 36 in sleeve 26 by focusing an objective lens 44 onto array 50 .

Signals generated by chip 46 are carried by wire 32 to handle 24 and from the handle via a cable 38 (FIG. 1) to a video cabinet where the signal is processed and used to drive a video display. Both the video cabinet and display (not shown) utilize standard video electronics well known in the art. Or, it is also possible to make the handle 24 contain a power source, such as one or several batteries, and a processing circuit and a video transmitter, and transmit the processed signal of the chip 46 to the video cabinet through a wireless connection.

The lights 42 preferably comprise white LEDs such as the T1 White L3-W31N LEDs produced by Sloan AG in Basel, Switzerland. These lights are powered by the current delivered by the video cabinet through the wires 32 and cables 38. Alternatively, these The light can also be powered by the aforementioned battery in the handle 24. In either case, the use of the light 42 eliminates the complexity and complexity of using high power fiber optic light sources to illuminate the viewing area in endoscopes known in the art. high cost.

The window 36 shown in FIG. 2 is relatively small in order to simplify the manufacture and reduce the cost of the sleeve 26 . Sleeve 26 also has a transparent area around the window to allow light from lamp 42 to reach the viewing area, but this area need not be of optical grade quality. In fact, the entire sleeve 26 could be made of clear plastic, if desired.

It should be noted that the optical axes of lenses 44 and array 50 are tilted at an angle relative to the longitudinal axis of unit 28 . The window 36 and the distal end of the sleeve 26 also have similar slope angles. This angle of inclination allows the camera 30 to view an area of the large bowel wall that is closer to the distal end of the insertion portion 22 than rigid rectal and sigmoidoscopes known in the art face directly against the large bowel. Due to this arrangement, the distal end of the insertion portion 22 can be made relatively narrow and tapered, making it easier to insert through the patient's anus without the need for a separate plug, while reducing the patient's pain. A knob 34 is preferably formed on the top of the distal end of the sleeve 26 and is preferably shaped to minimize discomfort to the patient when inserted into the anus.

The sleeve 26 preferably has at least one working channel 38 which defines an opening 52 at the distal end of the sleeve. The channel 38 can be used to insert surgical instruments such as medical forceps into the large intestine and perform surgical treatment under the monitoring of the camera 30 . Since the surgical instrument will be treating the wall of the large intestine within the camera's field of view, the oblique orientation of the camera described above will be particularly advantageous for monitoring such treatment.

Additionally or alternatively, channel 38 can also be used for aspiration, infusion and/or gas insufflation of the large intestine, as is known in the art, for which it is only necessary to connect the channel to a suitable pump or gas source . This connection is preferably made through the handle 24 and the aspiration, infusion or insufflation is preferably controlled by user controls 40 on the handle. Usually, it is desirable to inflate the large intestine during the examination to force the large intestine wall away from the window 36 so that the camera 30 can clearly see the large intestine wall. To this end, sleeve 26 preferably includes a one-way valve 54 in passage 38 thereof, such as a leaflet valve known in the art. After pressurized gas passes through the channel to inflate the large intestine, valve 54 will close to prevent backflow of gas and maintain pressure in the large intestine.

3A and 3B are schematic cross-sectional views illustrating a proctoscope 60 including a disposable sleeve 62 according to another preferred embodiment of the present invention. Proctoscope 60 contains a generally rigid insertion unit 28 with a video camera 30 at its distal end, which is substantially the same as the proctoscope in FIGS. is coincident with the longitudinal axis of unit 28.

Sleeve 62 includes an outer layer 64 and an inner layer 66 . The inner layer is preferably formed of a generally rigid plastic material such as polycarbonate and fits over the insert unit 28 . The inner layer 66 has a transparent distal portion, preferably having an optical window 68 therein, as previously described. The outer layer 64 is preferably made of a soft, resilient plastic such as polyethylene and has two or more vanes 70, preferably three vanes.

As shown in FIG. 3A , when the rectoscope 60 is inserted into the anus, the leaves 70 will come together to close the distal end of the rectoscope and protect the window 68 . The blades preferably form a blunt pointed structure for ease of insertion.

As shown in FIG. 3B , when inserted, each leaf 70 will be opened to expose the window 68 so that the camera 30 can receive images of the interior of the large intestine. Opening of the leaflets is preferably accomplished by pulling the outer layer 64 relative to the inner layer 66 in a proximal, ie, extrarectal, direction (to the right in FIGS. 3A and 3B ). Each vane 70 preferably has an inward projection 72 which maintains contact with the inner layer so that pulling will force the vane open, as shown in Figure 3B. After completion of the proctoscope procedure, the sleeve 62 can be returned to the shape of Figure 3A for removal through the anus.

Figure 4A is a schematic cross-sectional view illustrating the distal portion of a proctoscope 76 according to another preferred embodiment of the present invention. Proctoscope 76 is generally similar to proctoscope 20 shown in FIGS. 1 and 2 and includes insertion unit 28 with camera head 30 at its distal end. Proctoscope 76 is covered by a sleeve 78 which is similar to sleeve 26 except that it has a bulbous protrusion 80 protruding into the field of view of camera 30 . Affixed to protrusion 80 is a mirror 82 positioned and oriented such that an image of physiological structure 84 , typically the rectal wall, is reflected by the mirror and captured by camera 30 through window 36 . In the example shown in FIG. 4A , surgical instrument 88 is inserted through working channel 38 in sleeve 78 to collect a biological sample at location 86 on structure 84 .

FIG. 4B is a schematic diagram illustrating a video image 90 acquired with the proctoscope 76 configured in FIG. 4A. The upper portion of the image shows instrument 88 and structure 84 directly seen by camera 30 through window 36 . Due to the angle of view of the camera, the image of the instrument undergoes a distance-dependent foreshortening. Therefore, it is difficult to judge the distance between the instrument and the structure based on such an image alone. An inset 92 of the lower portion of image 90 shows instrument 88 and structure 84 as seen through mirror 82 . In this case, the angle at which the instrument is viewed makes it possible to clearly see the position of the instrument and its distance to the structure 84, which can be controlled with greater precision.

5A is a schematic cross-sectional view of the distal portion of a proctoscope 106 according to another preferred embodiment of the present invention. Proctoscope 106 is substantially similar to proctoscope 20 shown in FIGS. 1 and 2, except that its insertion unit 28 includes at least one soft, resilient portion 108. The elastic portion 108 preferably contains a spring element, such as a spring steel inserted therein, which under normal conditions keeps the elastic portion straight but allows it to bend when a lateral force is applied thereto. Preferably, the sleeve 26 of the proctoscope 106 comprises a soft and elastic material, such as polyethylene or silicone, so that when the elastic portion 108 bends, the sleeve bends and stretches accordingly.

The bending capability of the proctoscope 106 allows for easier insertion into the rectum to the sigmoid than a fully rigid proctoscope or sigmoidoscope and is less painful and uncomfortable for the patient. Prior art rigid proctoscopes cannot include a flexible portion like the proctoscope 106 because bending of the flexible portion would disrupt the optical axis of the telescope used for endoscopic viewing. While known art sigmoidoscopes can also be bent and can be inserted with less discomfort to the patient than rigid scopes, such flexible scopes require complex and expensive guiding mechanisms. By placing the camera head 30 at the distal end of the proctoscope 106, the present invention provides a flexible structure that does not require a guiding mechanism.

FIG. 5B shows a schematic cross-sectional view of a rectal inserter 102 that may be used for endoscopy and manipulation of a patient's large intestine 96 in accordance with a preferred embodiment of the present invention. Inserter 102 is particularly useful for guiding proctoscope 106 into the large intestine, but may also be used with conventional flexible endoscopes of the prior art. Inserter 102 is preferably made of a generally rigid but somewhat flexible plastic material such as polycarbonate to facilitate insertion. Inside the inserter is a curved channel 104 passing therethrough with an inner diameter sufficient to allow an endoscope, such as a proctoscope 106, to be inserted therethrough.

The inserter 102 is inserted into the rectum 98 up to the sigmoid curve 100 of the large intestine 96 . The inserter is then turned so that the opening of the channel 104 faces the sigmoid portion 101 of the large intestine, as shown in Figure 5B. The proctoscope 106 is then passed through the inserter as it bends to follow the curve of the channel. Advancement of the distal end of the proctoscope with camera 30 into the sigmoid colon 101 allows inspection and treatment of portions of the large intestine 96 that would otherwise be accessible only with conventional flexible endoscopes. The inserter 102 also prevents the area of the sigmoid curve 100 from pressure from the proctoscope (or a common flexible endoscope inserted through the inserter), which could otherwise cause pain or even perforation of the colon.

Fig. 6 is a schematic cross-sectional view of a proctoscope 110 including a guiding mechanism 111 according to another preferred embodiment of the present invention. Like some of the previous preferred embodiments, the proctoscope 110 also contains the insertion unit 28 and the camera head 30, which are covered by a disposable sleeve 112 with the optical window 36 at the distal end. The insertion unit 28 of the proctoscope 110 either includes a flexible portion as explained with reference to FIG. 5A , or is made flexible substantially over its entire length as shown in FIG. 6 .

The guide mechanism 111 includes two flexible, elongated air bladders 118 and 120 located in the sleeve 112, which are arranged on two diametrically opposite side walls of the insertion unit 28, respectively. The bladders 118 and 12 have inflatable wall portions 114 and 116, respectively, which are preferably accordion-folded walls as shown in FIG. The two balloons are respectively connected to a pressure source 126 through a valve 124, such as a gas bottle or an air pump. The valve and the pressure source can be included in the handle 122 of the proctoscope 110 or set in a separate control box. By manipulation of valve 124, bladders 118 and 120 will be pressurized to pressures P1 and P2, respectively. In the example shown in FIG. 6 , P1 > P2 , the wall portion 114 of the airbag 118 is expanded, and the wall portion 116 of the airbag 120 is contracted, thereby bending the insertion unit 28 .

In this way, mechanism 111 provides a simple, low cost, single-use device for controlled bending and guiding of proctoscope 110 by inflating or deflating two balloons 118 and 120 within sleeve 112 . To achieve greater control over the shape and direction of the bend of the rectoscope, more balloons may also be provided along the length and/or radial direction of the rectoscope. It should be noted that this pressure-actuated guiding mechanism can also be applied to other types of endoscopes, whether disposable or reusable.

It should also be noted that the various embodiments described above are given by way of example only, and that the full scope of the invention is defined only by the claims.

Claims (3)

1, a kind of video camera endoscope, it comprises: a generally rigid elongated insertion unit having a distal end and a proximal end; a video camera affixed to the distal end of the insertion unit; and a sleeve removably fitted over and covering the insertion unit, having a distal portion covering the video camera, at least a portion of the distal portion being substantially transparent, wherein the distal portion of the sleeve includes a narrow tip that facilitates insertion of the endoscope through the anus, and The narrow tip therein comprises two or more blades which are closed when inserted through the anus and which are opened after insertion to expose a transparent portion of the distal portion of the sleeve. 2. The endoscope according to claim 1, wherein to open the blades, the sleeve is pulled in a proximal direction relative to the insertion unit. 3. The endoscope of claim 1, wherein the sleeve includes a working channel extending longitudinally therethrough, and Wherein the sleeve contains a one-way valve in its working channel, which is used to prevent the backflow of the fluid flowing therein.

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